Ofsted reports are a key factor when a parent chooses a school for their child. Parents will review the report, checking that the proposed school meets the demands and needs of their child and that a good quality education can be expected. If parents want to ensure a school has a particular strength in a certain department or area, they can do so. If they are concerned about the school underperforming, the Ofsted report will highlight such failings and the school will seek to make improvements to ensure a better review and ratings at the time of the next inspection. The government, keen to be seen as providing a better quality NHS, at a time when budgets are being cut left right and centre, hopes that a similar system can be used in healthcare.
Speaking to the BBC this morning, Jeremy Hunt announcing his proposals stated "We are being bold enough and brave enough to do what no other country is doing, which is actually be honest about the quality of care in different places." He confirmed the ratings would be done in a "light touch way" and that "by being more transparent than ever before about crucial services and freeing up more time for GPs to care, we really can make NHS patients the most powerful in the world.
The aim of the proposals is to provide more options for patients who are concerned about the level of healthcare they are receiving at their local hospital and allow them to make a more informed decision as to where they wish to be treated. The idea of patient choice should be applauded. For too long patients have had to put up with poor quality care at their local hospital, but will "naming and shaming" the underperforming hospitals actually make any difference. What if a patient cannot travel beyond their local area and there are no other choices available to them? What if a patient is effectively left with the option of attending an underperforming hospital or no hospital at all? Might this policy lead to less people using the health service as they worry about the level of care they will receive? Will the expectant mother really be able to travel the extra distance to a better performing hospital when she goes into labour or will she still have to rely on the most local hospital regardless of the quality of their obstetric department? The answer, I suspect, will depend on the resources of the individual and the type of healthcare they are requiring.
Today's announcement follows on from the Care Quality Commission's (CQC) report which revealed that a staggering 76% of NHS hospital trusts were given an overall rating of "inadequate" or "requiring improvement" with 75% of hospitals branded unsafe. It is clear that the degree of variation across the country is unacceptable but is naming and shaming the best way to see better, standardised care? Rather than spending money on inspections, would it not be better to filter that money directly patient care. Those inspections that are announced are also likely to lead to misleading results as a hospital "puts on a good show" on the day of inspection, before resorting to mediocrity or worse thereafter.
Findings from the CQC suggest inspections do work. Their report revealed that half of health and care providers made some improvement within six months of inspection, and hospitals previously ranked as "inadequate" were now rated "moderate", "good" or even "outstanding" on occasion. On the basis of this finding I welcome today's announcement and hope, but do not necessarily expect, to see improvements to the level of patient care, once the new system is implemented.